| NPI | 1962794586 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner, Adult Health (Licence: MO 2011010360) |
| Additional Taxonomies | 363LF0000X Nurse Practitioner, Family (Licence: KS 53-75274) |
| Enumeration Date | 2011-05-16 |
| Last Update Date | 2016-12-07 |